Background Conflicting evidence surrounds the effect of dietary macronutrient intake (fat, carbohydrate and protein) on cardiovascular disease (CVD), particularly in women. Methods Women (aged 50–55 years) were recruited into the Australian Longitudinal Study on Women’s Health. Women were divided into quintiles according to their carbohydrate and saturated fat intake as a percentage of total energy intake (TEI). The primary endpoint was new-onset CVD (heart disease/stroke). Secondary endpoints included all-cause mortality, incident hypertension, obesity and/or diabetes mellitus. Multivariate logistic regression models assessed for associations with the primary and secondary endpoints, with adjustment for confounders. Results A total of 9899 women (mean age 52.5±1.5 years) were followed for 15 years, with 1199 incident CVD and 470 deaths. On multivariable analysis, higher carbohydrate intake was associated with lower CVD risk (ptrend<0.01), with the lowest CVD risk for quintile 3 (41.0%–44.3% energy as carbohydrate) versus quintile 1 (<37.1% energy as carbohydrate) (OR 0.56, 95% CI 0.35 to 0.91, p=0.02). There was no significant association between carbohydrate intake and mortality (ptrend=0.69) or between saturated fat intake and CVD (ptrend=0.29) or mortality (ptrend=0.25). Both increasing saturated fat and carbohydrate intake were significantly inversely associated with hypertension, diabetes mellitus and obesity (ptrend<0.01 for all). Conclusions In middle-aged Australian women, moderate carbohydrate intake (41.0%–44.3% of TEI) was associated with the lowest risk of CVD, without an effect on total mortality. Increasing saturated fat intake was not associated with CVD or mortality and instead correlated with lower rates of diabetes, hypertension and obesity. Data may be obtained from a third party and are not publicly available. The data from the Australian Longitudinal Study on Women's Health used in this analysis can be requested from the Data Access Committee of the University of Queensland ().

中文翻译：

---

澳大利亚女性碳水化合物和饱和脂肪摄入与心血管疾病和死亡率的关系

背景 相互矛盾的证据围绕着饮食中大量营养素摄入（脂肪、碳水化合物和蛋白质）对心血管疾病（CVD）的影响，尤其是在女性中。方法 女性（50-55 岁）被招募到澳大利亚女性健康纵向研究中。女性根据碳水化合物和饱和脂肪摄入量占总能量摄入量（TEI）的百分比分为五分之一。主要终点是新发心血管疾病（心脏病/中风）。次要终点包括全因死亡率、高血压、肥胖和/或糖尿病。多变量逻辑回归模型评估与主要和次要终点的关联，并调整混杂因素。结果共对9899名女性（平均年龄52.5±1.5岁）进行了15年的随访，其中1199人发生CVD，470人死亡。在多变量分析中，较高的碳水化合物摄入量与较低的 CVD 风险相关（ptrend<0.01），五分之一的 CVD 风险最低（41.0%–44.3% 的碳水化合物能量）与五分之一的 CVD 风险（<37.1% 的碳水化合物能量）（或0.56, 95% CI 0.35 至 0.91, p=0.02)。碳水化合物摄入量与死亡率（ptrend=0.69）或饱和脂肪摄入量与心血管疾病（ptrend=0.29）或死亡率（ptrend=0.25）之间没有显着关联。饱和脂肪和碳水化合物摄入量的增加均与高血压、糖尿病和肥胖呈显着负相关（ptrend<0.01）。结论 在澳大利亚中年女性中，适度摄入碳水化合物（TEI 的 41.0%–44.3%）与 CVD 风险最低相关，但对总死亡率没有影响。饱和脂肪摄入量的增加与心血管疾病或死亡率无关，而是与糖尿病、高血压和肥胖症的较低发病率相关。数据可能从第三方获得，并且不公开。本分析中使用的澳大利亚妇女健康纵向研究数据可向昆士兰大学数据访问委员会索取（）。